Comparison of different techniques of central venous pressure measurement in mechanically ventilated critically ill patients

Roger, C., Muller, L., Riou, B., Molinari, N., Louart, B., Kerbrat, H., Teboul, J-L. and Lefrant, J-Y. (2017) Comparison of different techniques of central venous pressure measurement in mechanically ventilated critically ill patients. British Journal of Anaesthesia, 118 2: 223-231. doi:10.1093/bja/aew386


Author Roger, C.
Muller, L.
Riou, B.
Molinari, N.
Louart, B.
Kerbrat, H.
Teboul, J-L.
Lefrant, J-Y.
Title Comparison of different techniques of central venous pressure measurement in mechanically ventilated critically ill patients
Journal name British Journal of Anaesthesia   Check publisher's open access policy
ISSN 0007-0912
1471-6771
Publication date 2017-01-18
Year available 2017
Sub-type Article (original research)
DOI 10.1093/bja/aew386
Open Access Status Not yet assessed
Volume 118
Issue 2
Start page 223
End page 231
Total pages 9
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Collection year 2018
Language eng
Formatted abstract
Background. Several techniques exist for measuring central venous pressure (CVP) but little information is available about the accuracy of each method. The aim of this study was to compare different methods of CVP measurements in mechanically ventilated patients.
Methods. CVP was measured in mechanically ventilated patients without spontaneous breathing using four different techniques: 1) end expiratory CVP measurement at the base of the” c” wave (CVPMEASURED), chosen as the reference method; 2) CVP measurement from the monitor averaging CVP over the cardiac and respiratory cycles (CVPMONITOR); 3) CVP measurement after a transient withdrawing of mechanical ventilation (CVPNADIR); 4) CVP measurement corrected for the transmitted respiratory pressure induced by intrinsic PEEP (calculated CVP: CVPCALCULATED). Bias, precision, limits of agreement, and proportions of outliers (difference > 2 mm Hg) were determined.
Results. Among 61 included patients, 103 CVP assessments were performed. CVPMONITOR bias [−0.87  (1.06) mm Hg] was significantly different from those of CVPCALCULATED [1.42  (1.07), P < 0.001 and CVPNADIR (1.04  (1.29), P < 0.001]. The limits of agreement of CVPMONITOR [−2.96 to 1.21 mm Hg] were not significantly different to those of CVPNADIR (−1.49 to 3.57 mm Hg, P = 0.39) and CVPCALCULATED (−0.68 to 3.53 mm Hg, P = 0.31). The proportion of outliers was not significantly different between CVPMONITOR (n = 5, 5%) and CVPNADIR (n = 9, 9%, P = 0.27) but was greater with CVPCALCULATED (n = 16, 15%, P = 0.01).
Conclusions. In mechanically ventilated patients, CVPMONITOR is a reliable method for assessing CVPMEASURED. Taking into account transmitted respiratory pressures, CVPCALCULATED had a higher proportion of outliers and precision than CVPNADIR.
Keyword Central venous pressure
Measurement
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
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